Inflammation associated with psoriatic arthritis can affect your entire body — not just your joints.
Psoriatic arthritis is a chronic inflammatory autoimmune disease that affects 10 to 30 percent of people with psoriasis, according to the National Psoriasis Foundation (NPF).
“Typically, psoriatic arthritis symptoms include pain, swelling, and stiffness that affect your joints — from the small joints of the hands and feet to the large joints of the hips and knees,” explains Rochelle Rosian, MD, a rheumatologist with the Cleveland Clinic in Ohio.
But these aren’t the only symptoms you may experience if you have psoriatic arthritis. Inflammation associated with the condition can cause a broad range of symptoms that can affect your entire body — from your head down to your toes. Being able to recognize these symptoms early allows you to immediately discuss them with your doctor so you can find the best treatment for you. Here’s what you need to know about psoriatic arthritis symptoms, as well as steps your doctor may recommend to get them under control.
Uveitis Can Cause Eye Pain and Redness
Psoriatic arthritis can cause inflammation, redness, and pain in the eyes, often accompanied by headache and blurred or reduced vision, Dr. Rosian says. About 7 percent of people with psoriatic arthritis develop uveitis, or inflammation of the inner area of the eye, according to the NPF. “This is much more than pink eye or conjunctivitis,” Rosian explains. Uveitis can lead to long-term for 1 last update 2020/05/31 consequences, including vision loss, if left untreated.Psoriatic arthritis can cause inflammation, redness, and pain in the eyes, often accompanied by headache and blurred or reduced vision, Dr. Rosian says. About 7 percent of people with psoriatic arthritis develop uveitis, or inflammation of the inner area of the eye, according to the NPF. “This is much more than pink eye or conjunctivitis,” Rosian explains. Uveitis can lead to long-term consequences, including vision loss, if left untreated.
Your doctor may prescribe steroid eye drops to help reduce inflammation. If those don’t work, you may need steroid pills or injections. On occasion, immunomodulators may be used to treat uveitis. Rosian stresses the importance of working with an ophthalmologist to protect your vision.
Inflammation of the Spine Can Lead to Stiffness
The spine can also be affected by psoriatic arthritis inflammation. This is called psoriatic spondylitis, which affects about 20 percent of those with psoriatic arthritis, according to the Spondylitis Association of America (SAA). The condition is characterized by large spurs that bridge, or grow over, the joints in the spine and ankylose, or fuse, Rosian explains. People with psoriatic arthritis may experience complete fusion of the spine, or it may only occur in certain areas such as the lower back or neck, says the SAA.
Many people with psoriatic arthritis experience stiffness lasting an hour or longer when they wake up in the morning. The discomfort can often be eased with nonsteroidal anti-inflammatory medications (NSAIDs), Rosian says.
Scaly Skin Is a Symptom of Psoriasis
About 85 percent of people with psoriatic arthritis first develop psoriasis symptoms on their skin, according to the NFP. Typical psoriasis symptoms include silvery-white or red patches of skin that reveal pinpoint bleeding if peeled away, says Linda Wong, MD, a dermatologist at Kaiser Permanente in Southern California. Psoriasis can also appear on the skin of the face, hands, feet, scalp, and even genitals.
The type of treatment can depend on what part of the body is affected, but over-the-counter 1 percent hydrocortisone creams and prescription medications can improve the skin. A generous slathering of a plain, thick moisturizer, such as petroleum jelly, can also ease symptoms, Dr. Wong says.
Swollen Fingers and Toes May Be Referred to as "Sausage Digits"
Another symptom of psoriatic arthritis is known as dactylitis, commonly called “sausage digit.” You may experience inflammation and swelling in just one finger or toe or in all of them on a hand or foot, which can also be swollen and red along the entire length. An analysis published in September 2014 in the World Journal of Orthopedics examined more than 850 studies on psoriatic arthritis and found that as many as 32 to 48 percent of patients with psoriatic arthritis had dactylitis. “This is because not only the joints but all the ligaments and tendons of the digit are affected, up to the most distal joint near the nail,” Rosian says. NSAIDs may help alleviate swelling and pain.
Psoriatic Arthritis May Increase Your Risk of Inflammatory Bowel Disease
Some people with psoriatic disease also face an increased risk of developing an inflammatory bowel disease like Crohn’s or ulcerative colitis. In an analysis of data from the Nurses’ Health Study published in July 2013 in the journal Annals of the Rheumatic Diseases, researchers at Brigham and Women’s Hospital and Harvard Medical School in Boston found that as many as 10 percent of women who had psoriasis at the start of the study had gone on to develop Crohn’s disease or ulcerative colitis.
Arthritis Curehow to Arthritis Cure for Don't ignore warning signs such as diarrhea or blood in the stool, Rosian says. Tell your primary care physician, who can work with your rheumatologist to address intestinal issues.
Enthesitis Can Cause Pain and Swelling in the Feet
People with psoriatic arthritis often develop enthesitis — swelling, tenderness, or pain caused by inflammation in areas where tendons or ligaments connect to bones. Common areas enthesitis may occur include the heel (Achilles tendinitis) and the sole of the foot (plantar fasciitis).
Gentle stretching, applying heat or ice, splinting, and taking certain medications can help control inflammation and ease pain, Rosian says.
Toenail and Fingernail Deformities Are Common With Psoriatic Arthritis
At least 80 percent of people with psoriatic arthritis will have nail problems, according to the NPF. Fingernails and toenails may develop holes or pits; separate from the nail bed; thicken; turn yellow or orange; or look deformed, Wong says. Nail psoriasis is hard to manage with topical medications, but phototherapy and corticosteroid injections into the nails may improve symptoms.